11 replies to this topic

[Prise]

Let's say, I have a person on my medical insurance. He or she isn't a spouse. Who is ultimately responsible for an unpaid bill by the secondary person?

I'm assuming it is the main account holder regardless of circumstances. However, if this is in collections, how would the main account holder's DV be handled by the CA since he isn't the patient? Nor, has he received any correspondence about the debt, nor has he known about it?

[mk_378]

Unless this person is your minor child, or your insurance company paid because of a mistake or fraud-- and now wants their money back, it doesn't seem that you'd ever be responsible.

[Why Chat]

Let's say, I have a person on my medical insurance. He or she isn't a spouse. Who is ultimately responsible for an unpaid bill by the secondary person?

I'm assuming it is the main account holder regardless of circumstances. However, if this is in collections, how would the main account holder's DV be handled by the CA since he isn't the patient? Nor, has he received any correspondence about the debt, nor has he known about it?

In general, your contract with your insurance Co. holds you liable for charges such as co-pays deductibles etc. for yourself or ANYONE ELSE who is an authorized covered party on your insurance. This is because the health care providers who agree to accept the insurance ( and the discounted fees) are guaranteed by the insurance Co. that you will pay the co-pays etc.
So, to answer your question, yes, you are responsible IF the "unpaid bills" are co pays etc.

Now, it is POSSIBLE that if the insurance was NOT used, or was incorrectly billed, you MAY be able to deny your responsibility. But the person whose name is on the insurance is the person whose credit report will get dinged.

[Prise]

Thanks for the replies guys. It is a valid medical debt incurred by a person who was under my insurance.

I've DV'ed the collection agency, but in this case, I'm sure they can't supply me with any information, since I wasn't the patient. No bills, communications, or any correspondence has ever been directed to me. In this case, if they don't DV, should I just pay the OC with the HIPAA letter with insert a?

Thanks!

[Why Chat]

Thanks for the replies guys. It is a valid medical debt incurred by a person who was under my insurance.

I've DV'ed the collection agency, but in this case, I'm sure they can't supply me with any information, since I wasn't the patient. No bills, communications, or any correspondence has ever been directed to me. In this case, if they don't DV, should I just pay the OC with the HIPAA letter with insert a?

Thanks!

Is it on your credit reports?? If so you can certainly send a dispute to the CRAs and a DV. Although the account MAY be valid insofar as the OC is concerned, unless it is a VERY recent account ( date of service) you have NO WAY of knowing if the CA is authorized to collect on the account.

Opt out
http://www.whychat.5...OPTOUTINST.HTML
Send any CRA where the account is reporting this
http://www.whychat.5.../hipaadisp.html
If it is not deleted, OR if it is not on your credit reports send the CA this:
http://www.whychat.5...cavalhipaa.html

IF you get a response that authenticates the current business relationship between the OC and the CA you can THEN pay the OC with the HIPAA letter insert "a"
http://www.whychat.5u.com/hipltr.html

[Prise]

Is it on your credit reports?? If so you can certainly send a dispute to the CRAs and a DV. Although the account MAY be valid insofar as the OC is concerned, unless it is a VERY recent account ( date of service) you have NO WAY of knowing if the CA is authorized to collect on the account.

Opt out
http://www.whychat.5...OPTOUTINST.HTML
Send any CRA where the account is reporting this
http://www.whychat.5.../hipaadisp.html
If it is not deleted, OR if it is not on your credit reports send the CA this:
http://www.whychat.5...cavalhipaa.html

IF you get a response that authenticates the current business relationship between the OC and the CA you can THEN pay the OC with the HIPAA letter insert "a"
http://www.whychat.5u.com/hipltr.html

What constitutes "very" recent? The original date of service is within 2 years.

I had no idea the debt existed, since I was never contacted. Now, I know why. It was reported on my credit reports about 5 or 6 months ago. It was quite an effort to even ascertain what it was pertaining to, since no one was willing to give me much information since I wasn't the patient in question.

I had already opted out. Also, I sent the HIPAA letter to the CRAs, and received notice they had valified the debt as belonging to me. It reads, "Creditor Class - Medical/Health Care; Client - ABC Medical....; Shared, But Otherwise Undesignated..."

I assume that is a ongoing business relationship?

Recently, I've also sent the DV to the CA. What if they don't reply to my DV?

[Prise]

Let's say, I have a person on my medical insurance. He or she isn't a spouse. Who is ultimately responsible for an unpaid bill by the secondary person?

I'm assuming it is the main account holder regardless of circumstances. However, if this is in collections, how would the main account holder's DV be handled by the CA since he isn't the patient? Nor, has he received any correspondence about the debt, nor has he known about it?

In general, your contract with your insurance Co. holds you liable for charges such as co-pays deductibles etc. for yourself or ANYONE ELSE who is an authorized covered party on your insurance. This is because the health care providers who agree to accept the insurance ( and the discounted fees) are guaranteed by the insurance Co. that you will pay the co-pays etc.
So, to answer your question, yes, you are responsible IF the "unpaid bills" are co pays etc.

Now, it is POSSIBLE that if the insurance was NOT used, or was incorrectly billed, you MAY be able to deny your responsibility. But the person whose name is on the insurance is the person whose credit report will get dinged.

Update...

Ok, it appears though the person was under my insurance at the time, these medical costs occurred when the insurance was already maximized. So, in essence, there was no copay, since my medical insurance refused any payment.

If there was no copay or insurance wasn't used, am I still liable? If I'm not liable, whose credit gets dinged? Mine, or the secondary who was using my insurance? At this point, I have no legal relationship with the said person.

I figured this out with the OC. The CA hasn't validated yet.

Thanks!

[Why Chat]

Let's say, I have a person on my medical insurance. He or she isn't a spouse. Who is ultimately responsible for an unpaid bill by the secondary person?

I'm assuming it is the main account holder regardless of circumstances. However, if this is in collections, how would the main account holder's DV be handled by the CA since he isn't the patient? Nor, has he received any correspondence about the debt, nor has he known about it?

In general, your contract with your insurance Co. holds you liable for charges such as co-pays deductibles etc. for yourself or ANYONE ELSE who is an authorized covered party on your insurance. This is because the health care providers who agree to accept the insurance ( and the discounted fees) are guaranteed by the insurance Co. that you will pay the co-pays etc.
So, to answer your question, yes, you are responsible IF the "unpaid bills" are co pays etc.

Now, it is POSSIBLE that if the insurance was NOT used, or was incorrectly billed, you MAY be able to deny your responsibility. But the person whose name is on the insurance is the person whose credit report will get dinged.

Update...

Ok, it appears though the person was under my insurance at the time, these medical costs occurred when the insurance was already maximized. So, in essence, there was no copay, since my medical insurance refused any payment.

If there was no copay or insurance wasn't used, am I still liable? If I'm not liable, whose credit gets dinged? Mine, or the secondary who was using my insurance? At this point, I have no legal relationship with the said person.

I figured this out with the OC. The CA hasn't validated yet.

Thanks!

If the OC treated the patient under the assumption that they were covered by insurance, then you are still liable. If they hadn't been admitted under your insurance then other payment arrangements would have been made at the time and your account information would not have been supplied. Consider it in the same way as giving the OC a check on your checking account that had NSF.

[Prise]

Let's say, I have a person on my medical insurance. He or she isn't a spouse. Who is ultimately responsible for an unpaid bill by the secondary person?

I'm assuming it is the main account holder regardless of circumstances. However, if this is in collections, how would the main account holder's DV be handled by the CA since he isn't the patient? Nor, has he received any correspondence about the debt, nor has he known about it?

In general, your contract with your insurance Co. holds you liable for charges such as co-pays deductibles etc. for yourself or ANYONE ELSE who is an authorized covered party on your insurance. This is because the health care providers who agree to accept the insurance ( and the discounted fees) are guaranteed by the insurance Co. that you will pay the co-pays etc.
So, to answer your question, yes, you are responsible IF the "unpaid bills" are co pays etc.

Now, it is POSSIBLE that if the insurance was NOT used, or was incorrectly billed, you MAY be able to deny your responsibility. But the person whose name is on the insurance is the person whose credit report will get dinged.

Update...

Ok, it appears though the person was under my insurance at the time, these medical costs occurred when the insurance was already maximized. So, in essence, there was no copay, since my medical insurance refused any payment.

If there was no copay or insurance wasn't used, am I still liable? If I'm not liable, whose credit gets dinged? Mine, or the secondary who was using my insurance? At this point, I have no legal relationship with the said person.

I figured this out with the OC. The CA hasn't validated yet.

Thanks!

If the OC treated the patient under the assumption that they were covered by insurance, then you are still liable. If they hadn't been admitted under your insurance then other payment arrangements would have been made at the time and your account information would not have been supplied. Consider it in the same way as giving the OC a check on your checking account that had NSF.

Ok, thanks, WhyChat. Very informative.

Final question before I send off the letter with "insert a" since I've verified with the OC "verbally" an ongoing business exists with the CA, though I've still to receive any form of validation from them.

Am I correct that for me to be liable, there must be an assumption the patient was covered under my insurance. Must they have made some kind of claim on my insurance before this condition is satisfied? And, if so, the bill for services rendered MUST be billed at the PPO group rate as per the agreement I have with my insurance carrier, right?

[Why Chat]

Let's say, I have a person on my medical insurance. He or she isn't a spouse. Who is ultimately responsible for an unpaid bill by the secondary person?

I'm assuming it is the main account holder regardless of circumstances. However, if this is in collections, how would the main account holder's DV be handled by the CA since he isn't the patient? Nor, has he received any correspondence about the debt, nor has he known about it?

In general, your contract with your insurance Co. holds you liable for charges such as co-pays deductibles etc. for yourself or ANYONE ELSE who is an authorized covered party on your insurance. This is because the health care providers who agree to accept the insurance ( and the discounted fees) are guaranteed by the insurance Co. that you will pay the co-pays etc.
So, to answer your question, yes, you are responsible IF the "unpaid bills" are co pays etc.

Now, it is POSSIBLE that if the insurance was NOT used, or was incorrectly billed, you MAY be able to deny your responsibility. But the person whose name is on the insurance is the person whose credit report will get dinged.

Update...

Ok, it appears though the person was under my insurance at the time, these medical costs occurred when the insurance was already maximized. So, in essence, there was no copay, since my medical insurance refused any payment.

If there was no copay or insurance wasn't used, am I still liable? If I'm not liable, whose credit gets dinged? Mine, or the secondary who was using my insurance? At this point, I have no legal relationship with the said person.

I figured this out with the OC. The CA hasn't validated yet.

Thanks!

If the OC treated the patient under the assumption that they were covered by insurance, then you are still liable. If they hadn't been admitted under your insurance then other payment arrangements would have been made at the time and your account information would not have been supplied. Consider it in the same way as giving the OC a check on your checking account that had NSF.

Ok, thanks, WhyChat. Very informative.

Final question before I send off the letter with "insert a" since I've verified with the OC "verbally" an ongoing business exists with the CA, though I've still to receive any form of validation from them.

Am I correct that for me to be liable, there must be an assumption the patient was covered under my insurance. Must they have made some kind of claim on my insurance before this condition is satisfied? And, if so, the bill for services rendered MUST be billed at the PPO group rate as per the agreement I have with my insurance carrier, right?

WELL--- They got YOUR data from somewhere!! It's on YOUR credit report!! They had to have obtained the insurance information from the patient.

And yes, get an EOMB from your insurance Co. the bill WAS submitted to them and if it had NOT been maxed out they would have paid the discounted amount, find out what that would have been, preferably in writing from your insurance Co. and include that with the payment.

[Prise]

Thanks WhyChat!

After following with payment insert "a," I received a correspondence from the medical provider's attorney that since the account has been paid in full, the derog will be removed from my cra.

How long should I accord the CA to remove the entry before commencing with the follow-up letters after the insert "c" section?

Thanks again!

[Why Chat]

Thanks WhyChat!

After following with payment insert "a," I received a correspondence from the medical provider's attorney that since the account has been paid in full, the derog will be removed from my cra.

How long should I accord the CA to remove the entry before commencing with the follow-up letters after the insert "c" section?

Thanks again!

Check your reports ( back door) in 3 weeks, make sure the account wasn't changed to a "paid" collection. If there is no change, or if it has been changed to a "paid" collection use the follow up dispute and cover letter.